Crystalline Lens Power and Associated Factors in Highly Myopic Children and Adolescents Aged 4 to 19 Years

PURPOSE: To investigate the distribution characteris-tics of lens power in highly myopic Chinese children and adolescents and its association with age, axial length (AL), and spherical equivalent (SE). DESIGN: Cross-sectional study. METHODS: A total of 459 highly myopic (SE <=-5 diopter [D]) children and adolescents aged 4-19 years were included in the study. Participants underwent a se-ries of ophthalmic examinations, which included AL, cycloplegic refraction, and Pentacam measurements. Lens power was calculated using Bennett's formula with its distribution described by age, AL, and SE. Multi-ple regression was conducted to analyze the associated factors of lens power. RESULTS: Greater lens power was independently asso-ciated with younger age, girls, shorter AL, and thicker lens thickness (standardized b [-0.203, 0.214,-0.379 and 0.492, respectively; all P < .001). However, a significant difference in lens power with age was only found in participants younger than 9 years, after which it reached a plateau (mean difference of 1.23 and 0.084 D per age group, respectively). Lens power was negatively associated with AL only in participants with AL <27 mm. No correlation was observed between lens power and SE. CONCLUSION: Among highly myopic children and ado-lescents, differences in lens power with age declined significantly after 9 years of age, which was 1 year earlier than non-high myopic patients in previous studies, which implied differences in pathophysiological process between non-high myopia and high myopia. The decoupling of lens power and AL in eyes >27 mm might represent the limited influence of AL on lens power. (Am J Ophthalmol 2021;223:169-177. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).)